I-131 accumulation in gastric pull-up simulating pulmonary metastases on total-body scan for thyroid cancer.
A follow-up total-body I-131 scan in a patient with follicular thyroid carcinoma demonstrated radionuclide accumulation in the right hemithorax. Originally thought to be pulmonary metastatic thyroid carcinoma, the uptake region proved to be intrathoracic gastric mucosa. The patient had been treated for squamous cell esophageal carcinoma by esophagogastrostomy reconstruction with gastric pull-up. This unusual imaging pattern could have been interpreted as metastatic disease in the absence of complete patient records, an appreciation of normal gastric concentration patterns of I-131, and corroborative imaging study analysis.
White
J E
JE
Department of Radiology, Medical College of Georgia, Augusta.
Flickinger
F W
FW
Morgan
M E
ME
D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003937:Diagnosis, Differential; D004938:Esophageal Neoplasms / Q000601:surgery; D005753:Gastric Mucosa / Q000000981:diagnostic imaging*; D005774:Gastrostomy; D006801:Humans; D007457:Iodine Radioisotopes; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D011877:Radionuclide Imaging; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging*
D007457:Iodine Radioisotopes